{"id":3687,"date":"2025-03-31T18:11:47","date_gmt":"2025-03-31T18:11:47","guid":{"rendered":"https:\/\/kidneydiseaseclinic.net\/kdc\/amphotericin-txt\/"},"modified":"2025-03-31T18:11:47","modified_gmt":"2025-03-31T18:11:47","slug":"amphotericin-txt","status":"publish","type":"post","link":"https:\/\/kidneydiseaseclinic.net\/kdc\/amphotericin-txt\/","title":{"rendered":"Amphotericin.txt"},"content":{"rendered":"

Amphotericin<\/h1>\n

CLINICAL USE <\/H3>
\nAntifungal agent:<\/p>\n
  • Systemic fungal infections (yeasts and\n

    yeast-like fungi including Candida
    \nalbicans
    \n

    DOSE IN NORMAL RENAL FUNCTION <\/H3>
    \n5 mg\/kg\/day for at least 14 days (see
    \nindividual product data sheet)
    \n

    PHARMACOKINETICS <\/H3>
    \n
  • Molecular weight &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :
    \n924.1\n<\/li>\n
  • %Protein binding &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :
    \n90\n<\/li>\n
  • %Excreted unchanged in urine &nbsp &nbsp :
    \n<1\n<\/li>\n

  • Volume of distribution (L\/kg) &nbsp &nbsp &nbsp :
    \n2286\n<\/li>\n

  • half-life \u2013 normal\/ESRD (hrs)&nbsp &nbsp &nbsp :
    \n173.4\/Unchanged
    \n

    DOSE IN RENAL IMPAIRMENT <\/H3>
    \n

    GFR (mL\/MIN)<\/H4>
    \n
  • 20 to 50 &nbsp &nbsp : Dose as in normal renal function
    \n
  • 10 to 20 &nbsp &nbsp : Dose as in normal renal function
    \n
  • <10 &nbsp &nbsp &nbsp &nbsp &nbsp :
    \nDose as in normal renal function
    \n

    DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES <\/H3>
    \n
  • CAPD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp:
    \nNot dialysed. Dose as in normal renal function<\/p>\n
  • HD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :
    \nNot dialysed. Dose as in normal renal function
    \n
  • HDF\/high flux &nbsp :
    \nUnknown dialysability. Dose as in
    \nnormal renal function
    \n
  • CAV\/VVHD &nbsp &nbsp &nbsp:
    \nNot dialysed. Dose as in normal renal function
    \n

    IMPORTANT DRUG INTERACTIONS <\/H3>
    \nPotentially hazardous interactions with other drugs<\/p>\n
  • Ciclosporin: increased nephrotoxicity\n
  • Tacrolimus: increased nephrotoxicity\n
  • Increased risk of nephrotoxicity with\n

    aminoglycosides and other nephrotoxic
    \nagents and cytotoxics<\/p>\n

  • Cardiac glycosides: increased toxicity if\n

    hypokalaemia occurs<\/p>\n

  • Corticosteroids: increased risk of\n

    hypokalaemia (avoid concomitant use
    \nunless corticosteroids are required to
    \ncontrol reactions)<\/p>\n

  • Flucytosine: enhanced toxicity in\n

    combination with amphotericin
    \n

    ADMINISTRATION <\/H3>
    \n

    Reconstition<\/H4>
    \nSee individual data sheet. Prepare <\/p>\n

    intermittent infusion in glucose 5%
    \n(incompatible with sodium chloride 0.9%,
    \nelectrolytes or other drugs). <\/p>\n

  • Dilute to a concentration of 1\u20132 mg\/mL\n

    Route <\/H4>
    \n

    IV infusion <\/H4><\/p>\n

    Rate of Administration <\/H4>
    \n2.5 mg\/kg\/hour <\/p>\n

    Comments<\/H4><\/p>\n
  • Paracetamol and parenteral pethidine\n

    may alleviate rigors associated with
    \namphotericin administration. Can also use
    \nantihistamines to control reactions<\/p>\n

  • Flush existing IV line with glucose 5%\n

    before and after infusion administration<\/p>\n

  • For patients on CAV\/VVHD, amphotericin\n

    should be given into the venous return of
    \nthe dialysis circuit
    \nShould be given post dialysis<\/p>\n

    OTHER INFORMATION <\/H4>
    \n*** AMPHOTERICIN IS HIGHLY
    \nNEPHROTOXIC ***<\/p>\n
  • Can cause distal tubular acidosis\n
  • May cause polyurea, hypovolaemia,\n

    hypokalaemia and acidosis. <\/p>\n

  • Amphotericin and flucytosine act\n

    synergistically when co-administered
    \nenabling lower doses to be used effectively<\/p>\n

  • A test dose of amphotericin is\n

    recommended at the beginning of a new
    \ncourse (1 mg over 15 minutes)<\/p>\n

  • Monitor renal function, full blood count,\n

    potassium, magnesium and calcium levels<\/p>\n

  • Liposomal amphotericin is considerably\n

    less nephrotoxic compared with
    \nconventional amphotericin B, but is
    \nconsiderably more expensive<\/p>\n","protected":false},"excerpt":{"rendered":"

    Amphotericin CLINICAL USE Antifungal agent: Systemic fungal infections (yeasts and<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[7],"class_list":["post-3687","post","type-post","status-publish","format-standard","hentry","category-blog","tag-post-by-auto-php"],"_links":{"self":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts\/3687","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/comments?post=3687"}],"version-history":[{"count":0,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts\/3687\/revisions"}],"wp:attachment":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/media?parent=3687"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/categories?post=3687"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/tags?post=3687"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}